If you’re a new runner, you’re probably discovering firsthand the insane amount of benefits running gives you. And that is a fantastic thing. What’s not so awesome? Getting an injury that keeps you from progressing as a runner or even running at all. Bummer alert: New research published in the journal PLOS ONE found that this ends up happening to about 25 percent of novice runners.
Researchers from Aarhus University in Denmark examined a previous study on 933 new runners. Of those studied, 25 percent experienced running-related injuries within nearly 23 miles (to put it another way, that would translate into about 10 two- to three-mile runs). While the injuries varied a lot, the most common were shin splints, runner’s knee, medial meniscal injury (a.k.a. damaged knee cartilage), Achilles tendinopathy (a.k.a. inflammation in your Achilles tendon), and plantar fasciitis (a tightening of connective tissue in your foot), respectively.
And while 25 percent isn’t the majority, the lesson here is that many running newbies need to be more careful before they hit the road. So we talked to experts to get the rundown on common mistakes to avoid and how to keep injuries at bay:
MORE: Running Tips: How To Get Started
The Number One Rule of Starting to Run
You must take it slow. One of the biggest pitfalls of newbie runners is thinking that you need to start out running non-stop without any walk breaks, says Jeff Galloway, an Olympic distance runner and co-author ofWomen’s Guide to Running. When people can’t run without stopping, they think that they aren’t meant to run at all, he says. But the truth is, people shouldn’t even make it a goal to run without stopping. Galloway says inserting walking breaks into your run gives your body a chance to reduce fluid loss (a.k.a. sweating), lowers your chances of being injured, and lessens the stress running puts on your body.
When you first take up running, Galloway recommends shooting for a walking distance that’s only slightly longer than you’re normally comfortable walking. Then, start inserting short running segments into that walk. Over time, you can increase your distance and the length of your jogging segments. But, says Galloway, don’t increase your distance more than a mile at a time. Your ultimate goal here is to maintain a comfortable pace without any “huffing and puffing” or pain, he says.
Worried that you won’t get calorie-burning benefits of a run if you take your time? Here’s the thing: When you start out too fast, you could hit a wall halfway through, which could lead not only to a greater risk of injuries but to a shorter run, says Galloway. That means you’ll probably burn the same amount of calories when you do a slower run because you’ll be able to go longer (and eventually keep building up from there).
MORE:101 Greatest Running Tips
The Injuries You Should Watch Out for
Even if you are taking your runs nice and slow, little things like your form, muscle strength, flexibility, and even your shoes can make you vulnerable to common new runner injuries, says Jordan Metzl, M.D., an exercise physician and author of The Exercise Cure. Here, how to try to avoid them:
Shin Splints: Out of the 254 new runners who reported injuries in the study above, the number-one complaint was shin splints. This sharp pain in your legs below the knee happens when running puts too much pressure on your tibia bone, says Metzl. He says this injury usually occurs because your muscles aren’t strong enough to take the pressure off your bone, because your foot is rolling inward, or because you’re taking strides that are too long. To combat these mishaps before they happen, Metzl suggests incorporating strengthening moves like plyometric squats jumps, split squats, or toe touches into your workouts to strengthen your muscles and protect your form. Another way to prevent this super common injury is to get fitted for shoes at a specialty running shoe store. The staff can help you figure out how you run and where your feet need more support. To avoid over-striding, Metzl suggests aiming to have your left foot hit the ground between 85 and 90 times per minute, which you can measure by counting how many times it touches the ground within that time frame.
And if you’ve already come down with this pesky pain in your legs, don’t try to push through it, because it can lead to a serious stress fracture, says Metzl. Instead, start cross training by biking, doing yoga, or strength training, and keep the pressure off your lower legs until the pain goes away.
Runner’s Knee: The second most frequently reported injury in new runners was runner’s knee. Metzl says this knee pain feels a bit like “a toothache under your knee cap,” meaning a dull, achy pain that flares up when you run, walk down stairs, or stand up after sitting. Similar to shin splints, runner’s knee can be prevented by strengthening your glutes, quads, and hips (using the same moves Metzl recommended for shin splints), shortening your stride, and making sure your feet aren’t rolling inward when you run (this is where that expert shoe fitting will really help you out). Plus, start showing the foam roller some love to maintain flexible quads, glutes, and hips, says Metzl. This can prevent tight muscles from pulling on the area around your knee, which can irritate it.
If you already have runner’s knee, you can keep running, says Metzl, as long as it doesn’t get worse or start to impact your form.
Medial Meniscal Injury: This injury, which was the third most common, happens when the cartilage between the bones becomes torn or damaged and feels like a sharp pain on the inside of your knee. You might also feel some “clicking” sensations. And while it’s one of the most reported injuries in this study of new runners, Metzl says that it’s seen more frequently in people who participate in sports with a lot of twisting and turning. The good news is that not everyone who feels he or she has this injury needs to have any surgery or even stop running. Metzl recommends seeing your doctor as soon as possible. Although he said it’s hard to say what causes this (genetics may have something to do with it, he says), you can try to prevent it by keeping those key lower-body muscles mentioned earlier strong.
Achilles Tendinopathy: This achiness in the Achilles tendon was the fourth most common injury in the study, and it should be a red flag that you need to take a break from hitting the road, says Metzl. It’s caused by inflammation and irritation in your Achilles tendon and can get worse really fast. Metzl recommends icing the area to reduce the inflammation and seeing your doctor right away. To avoid hitting this newbie runner roadblock, Metzl says to stretch out your calves by doing a runner’s stretch: Step your right foot forward and lower into a lunge with your fingertips on the floor, then straighten your right leg, hold, and repeat on the other side. This helps keep tight muscles in your lower legs from putting pressure on this area.
Plantar Fasciitis: The common injury that Metzl calls “the bane of runners” is plantar fasciitis, and it was number five in the study. This usually starts off feeling like a dull ache on the inside part of your foot near your heel when you get out of bed in the morning and can get worse very quickly, he says. Here’s how it happens: When your calf muscles are too tight, they pull on your heel bone, which is attached to a band of connective tissue called the plantar fascia, and cause a ton of pain. To prevent this injury, which can take a long time to heal, make sure you’re stretching out your calves frequently by using a foam roller, says Metzl. This helps keep your calves from pulling on your heel. Metzl also suggests rolling your arch over a golf ball to loosen up that area. If you think you have plantar fasciitis, stop running, use ice to reduce some of the pain, and check in with your doctor right away since this injury is tough to heal and can escalate quickly.
MORE: 3 Steps to Become a Runner
If you suspect that you might be injured from running, assess your body, says Metzl. Sign number one of a potential injury: The pain is affecting your exercise form. Sign number two: The pain gets worse (soreness, on the other hand, lessens as you move through a workout). If you experience either of those things, visit your doctor and don’t try to push through the pain.
Run the Women’s Health RUN 10 FEED 10 Race in New York City on September 21—or take part in one of our other runs around the country, or even sign up to run your own 10-K! You’ll feed 10 hungry people in your neighborhood just by signing up.
MORE:When Should You Skip a Big Workout or Race?
Ashley Oerman Deputy Lifestyle Director Ashley Oerman is the deputy lifestyle director at Cosmopolitan, covering fitness, health, food, cocktails, home, and entertainment.
So you’ve got knee pain from running. Whether you’re a complete beginner, or you’re two weeks into your latest marathon training cycle, knee pain is frustrating. We spoke to sports doctor Jordan Metzl, who explains four of the most common causes of knee pain from running, and what you can do about them:
- Why do my knees hurt after running?
- 1. Runner’s knee
- 2. Patellar tendinitis
- 3. Iliotibial band syndrome
- 4. Osteoarthritis
- My knees hurt a lot after jogging, am I doing something wrong?
- New to the Running World? Your Questions Answered
- Why do my knees hurt?
- What should I eat before a run?
- How many times a week should I run?
- How do I get faster?
- How can I get rid of a stitch?
- RunnersConnect Insider Bonus
- Runner’s Knee Pain: Causes, Symptoms, and How to Fix It
- What Is Runners’ Knee?
- What Causes Knee Pain When Running?
- Runner’s Knee Symptoms
- How to Fix Runners’ Knee
- Preventing Runners’ Knee
- Common Knee Injuries from Running
- Runners’ Knee Pain
- Outside Knee Pain: Running with ITBS
- Inner Knee Pain: Running & Plica Syndrome
- Running Injuries: Knee Bursitis
- Knee Pain Running Treatment
- 5 Beginner Running Injuries (and How to Avoid Each)
- Runner’s Knee
- Iliotibial Band Syndrome
- Plantar Fasciitis
- Piriformis Syndrome
- Posterior Tibialis Tendonitis
- Knee pain in a beginner runner- rest more, get a brace/sleeve, or ignore?
Why do my knees hurt after running?
Why do you run? Because it feels good. Because it relieves stress. Because it enables you to eat cake. I get that, because running is also important to me. I’m a 32-time marathoner who knows how frustrating it is to be injured. It’s the reason I became a sports doctor. Ripping my anterior cruciate ligament playing football when I was in medical school was devastating, but it was the single most important event to influence my work. It’s what drives me to help my patients. Almost every day I treat runners with achy knees. Many are freaked out: can I still run? Will I have to switch to swimming? Thankfully, most knee problems won’t keep you off the road for long. Here’s what you need to know about common knee injuries.
1. Runner’s knee
Where does it hurt? Pain under your kneecap that feels worse after running and when you walk up or down stairs.
What’s going on? When the patella moves out of alignment during running, the cartilage beneath it becomes irritated.
- Reduce mileage
- Cross-train with activities that don’t aggravate your knee
- Apply ice for 15 minutes five times a day
- Take an anti-inflammatory
- Foam roll your quads
- If the pain continues, see a doctor
- Strength train
- Foam roll daily
- Shortening your stride can take pressure off your knees. Aim for 170-180 footstrikes per minute
2. Patellar tendinitis
Where does it hurt? Pain below your kneecap and at the top of your shin; it sharpens on the run. Also hurts going up or down stairs.
What’s going on? The force placed on the knee during running can sometimes put too much strain on the patellar tendon.
- Stop running until you can do so pain-free; cross-train instead
- Apply ice for 15 minutes five times a day
- A patellar tendon strap can reduce pain
- If it doesn’t improve, see a doctor
- Strength train
- Stretch your quads and hamstrings
- Foam roll daily
3. Iliotibial band syndrome
Where does it hurt? Pain on the outside of your knee. It usually comes on five minutes into a run and subsides when you’re finished.
What’s going on? The iliotibial band (ITB) runs from your hip to your knee, crossing the knee joint. A fluid-filled sac called the bursa sits between the ITB and the outside of your femur, near your knee. When the ITB is tight, the bursa gets squeezed, causing pain.
- You can run unless pain forces a change in your form. Reduce your mileage and cross-train
- Foam roll your ITB on the soft part of your outer thigh
- If you overpronate, wear motion-control shoes
- See a doctor if it persists
- Strong glute and core muscles are key
- Foam roll your ITB daily
- A shorter, quicker stride can help. Aim for 170-180 footstrikes per minute
Where does it hurt?
Pain, swelling and stiffness in your knee during running or even day-to-day activities.
What’s going on?
The wearing out of hyaline cartilage (lining of the joint) causes bone to grind on bone.
- Keep moving. Activity keeps joints lubricated
- Take an anti-inflammatory
- Run on soft surfaces
- See a doctor
- Strength train
Recover like a pro
My knees hurt a lot after jogging, am I doing something wrong?
It is common for joggers to have knee pain. It is usually due to a combination of improper strength and flexibility not only at the knee, but also the hip and ankle/foot. The hip is designed to absorb a majority of shock, as well as produce power through the gluteal muscles. The ankle/foot contacts the ground and provides proper ground reaction forces up the kinetic chain. If the hip or ankle/foot do not work correctly, the knee undergoes increased stress. Like a paper clip bending repetitively, injuries at the knee can then occur. In runners, pain can present itself in the front (i.e. patellar pain), lateral portion (i.e. iliotibial band syndrome), or along the medial knee (i.e. ligament or meniscus injury). It is important to address proper mechanics through the entire leg to allow a jogger to run efficiently without causing further injury.
If running is causing more pain in the knee, it is recommended not to “run through the pain” but rather limit the running by staying short of pain getting worse. Take the time outside of running to address proper strength, flexibility of both legs and core stability to provide efficient mechanics to jog at the distance/intensity you are striving for. Fitting of running shoes for your foot type and/or full-length orthotics should be considered as well as contacting a running coach to assess your stride and running mechanics.
What causes it: “There’s a muscle that attaches to the back of the shin bone and that muscle wraps around the inside of the ankle bone and helps to control the foot when it pronates , and also helps during push-off to propel you forward,” Ferber explains. Shin splints happen when there’s repetitive trauma to the connective tissue that attaches this muscle to the tibia bone, says Gallucci. The tissue breaks down, becomes inflamed, and sometimes, scar tissue forms during the healing process, “which produces pain and tightness.”
How to fix it: Getting running sneakers with more cushioning is a good start, but shoe choice is just a minor part of this, Ferber says. “The true fix is strengthening.” He tells patients to follow a heel raises program (check it out here) to strengthen the calves and ankles.
3. Plantar fasciitis
What it is: Plantar fasciitis causes a stabbing pain on the bottom of the foot near the heel. “It’s usually a little bit stiff at the beginning of a run and then the pain goes away. Then, it’s a little stiff when you finish,” says Ferber. “But it hurts first thing in the morning. That first step out of bed is excruciating at the heel. It can take 15 to 30 steps to get it warmed up and to go away, and then you kind of forget about it.”
What causes it: The plantar fascia is a thick band of connective tissue that runs along the sole of the foot from the toes to the heel. Its job is to support your arch, Ferber says. “It gets stretched every time the foot comes down, and rung back out as the foot pronates,” he explains. It’s designed to be thick enough to withstand these forces, but too much repeated tension on the fascia can cause irritation and inflammation.
Since the fascia is connected to so many parts of your foot and leg, there are many things that can contribute to plantar fasciitis. “Poor running mechanics, flat feet, weakness of the hips, weakness of the core, poor control of pelvic positioning, and nerve irritation in the lower back,” can all contribute to this inflammation and pain, Licameli says. Tight calf muscles or even inflexible toes can strain this connective tissue, too, adds Ferber.
How to fix it: “We say to stretch and do heel raises to make sure the muscles crossing underneath the foot are good and strong. That takes the load off the plantar fascia,” Ferber says. “Plus, a good arch support (just an over-the-counter orthotic) will take some stress off.” Licameli also suggests strengthening the hips and the core (try this core workout for runners). “And always warm up properly,” he says.
4. Achilles tentonitis
What it is: This type of tendon injury causes inflammation and pain in the Achilles tendon, “especially when walking, running, raising up on toes, and stretching the calf muscles,” Licameli says. It’s an aching, dull pain, “usually right where the muscle transitions to tendon,” Ferber says. The pain can also be deeper in the thickest part of your tendon, which is more common as you age. Why? “As you age, you lose blood supply in the mid part of the Achilles tendon and it becomes brittle. It starts happening in about your 40s,” Ferber explains.
What causes it: Any weakness or tightness in the calves, glutes, or hamstrings can impact the Achilles tendon. We use our calf muscles and glutes to propel us forward, and if they’re not their doing jobs, smaller things like tendons have to kind of take over, which can end up causing a lot of strain. Licameli adds that having weak hips or core or flat feet can all impact how much strain is on the Achilles tendon.
How to fix it: Again, strengthening and stretching the muscles at play is key here. Often it’s the hips or calves that need to be strengthened, but issues with the feet are core are common, too. Ferber adds that since there can be so many different causes, you need to figure out the main one in order to properly treat it—that’s why it’s so important to see a professional to help you get to the bottom of it.
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New to the Running World? Your Questions Answered
In my 20 years of working with runners, there are some questions that crop up time and time again.
These are undoubtedly the five most commonly asked questions, especially by beginners. However, as the years have gone by, my answers have changed in line with research and advances in sports science.
Here’s the current thinking:
Why do my knees hurt?
Where to start? This is probably the number one question I get, and the hardest to answer. Knee pain in runners is common; a review paper in the BMJ in 2007 actually found that the .
Pain can be ‘on’, ‘in’ or ‘around’ the actual kneecap itself (often described as runners knee), or on the medial or lateral edge (ITB syndrome) of the knee.
However, unless you have had a fall or acute injury to the knee itself, ‘vague’ knee pain is usually a symptom of; overdoing mileage; the wrong shoes; or of some sort of imbalance, tightness or weakness elsewhere.
Beginner runners are especially vulnerable due to a lack of general conditioning and muscle strength.
But don’t panic if you’re a new runner, and have developed knee pain.. it’s unlikely to be arthritis; a study in 2014 actually found that running may actually help prevent osteoarthritis caused by ‘pounding’ the pavements
You also do not need a referral to an orthopedic surgeon, or to spend a great deal of money on orthotics.
More often than not, most cases of ‘knee pain’ in runners can be easily addressed with a combination of Rest, Ice, Compression, and Elevation; corrective exercises (usually for the glutes, abductors and hip rotators); the right shoe choice; soft tissue release of the quads and hip flexors through massage and foam rolling (ideally every day); and a bit of patience.
In the future, be careful with how quickly you increase your mileage, and try to include pilates and some strength and conditioning exercises to supplement your running. The use of kinesiology tape may help too.
Exclusive bonus: Download our full Runner’s Knee Prevention Routine. It’s a PDF with images and descriptions of the 10 most effective prevention and rehab exercises for runners with Runner’s Knee issues. .
Our hip strengthening for runners routine (called Bia), which can be sampled here, and our preventive routines available in our strength training for runners program incorporate these functional and balance exercises gleaned from the research to help keep you healthy.
The most important thing is not to give up running, or just ‘rest’ and wait for your knees to get better. Be proactive, get advice and treatment from a physical therapist and use the ‘downtime’ to work on your exercises.
What should I eat before a run?
There’s no simple answer to this one either.
What you eat before a run depends on many things – the time of day, your food preferences, the distance and intensity of your run, your weight management strategy, and your personal physiology.
We have three posts on what to eat before runs
Should I Eat Before I Run? How to Fuel Your Body for Any Running Workout
What to Eat Before and After Easy Runs, Long Runs and Different Types of Workouts
The Glycemic Index: How it can help you find the best foods to eat before, during and after running
The timing and volume of what you eat needs to vary depending on how far you plan to run and your personal response to feeding.
If for example you plan to run for 2-3 hours at 7am, you will need to fuel with a carb rich meal the night before, and then top up with some of the foods listed above around 2 hours before your run.
A short evening run might only require a mid afternoon snack (a yogurt and banana for example) 90 minutes beforehand, and then your normal dinner afterwards.
My advice to runners has always been to keep it fairly simple; do not overeat carbohydrate in general, and try to time food intake accordingly.
Like all things in running, research findings are constantly changing the goal-posts. Whilst not exactly new, the concept of ‘train low, race high’ is popular in some running circles.
The theory being that exercising in a glycogen-depleted state will stimulate an improved training adaption and ability to burn fat. The research is far from conclusive, but if you want to try it, keep the intensity low and duration short; only restrict carbohydrate before and during the run itself, eating normally the rest of the day.
The bottom line?
Experiment and find meals and snacks that work for you; both in terms of practicality, but also in your gastric response, energy levels for exercise, and recovery.
My simple rule of thumb? Never train ‘stuffed’ or ‘starving’. Keep things simple and eat what you enjoy!
How many times a week should I run?
Again, this is another grey area!
How often you run, will depend on your exercise background, ‘running age’ (how long you have been running for), your chronological age, history of injuries, ability to recover and lifestyle.
I have known fit dog walkers take up running in their 50s’ who can quite easily manage 4-5 runs per week without any problems.
On the other hand, sedentary office workers who are overweight, and have no background in fitness may need to restrict their runs to twice a week to begin with.
However, for the vast majority of competitive recreational runners (even marathon runners) who also have busy lives, families and jobs, I recommend building up to running no more than 4 (maybe 5) times per week as a maximum.
It is important to supplement these runs with cross training, strength work and pilates. You will still be exercising 6-7 times per week, but the variation of training will reduce risk of injury and maintain more consistency.
For complete beginners, I recommend no more than twice per week to start with – supplemented with brisk walking and cross training – building up to 3 times per week.
Start gradually and ‘test’ out your tolerance. Run twice a week to begin with, after two months and no injuries, then increase to three times per week, and see how you go.
Keep monitoring your body for niggles and injuries and drop back accordingly. As you get fitter, you will find you can run more frequently. But start gradually and build up slowly!
Improved ‘recovery’ – not necessarily performance – is a great indicator of improving fitness. The faster you recover between sessions, the fitter you are becoming. Mix it up with cycling, swimming and strength work for better consistency and keep running in balance.
How do I get faster?
When you first start running, you will see rapid improvement; the personal records will come thick and fast.
However, most people hit a plateau after a little while, and the question of ‘How do I get faster?’ inevitably crops up.
It is at this stage that frustrated runners do one of three things 1) run more miles 2) race more often or 3) do loads of speedwork… or all three! Which usually ends in disaster.
Getting ‘faster’ isn’t an exact science (is there ever?) and there are a number of factors to consider…. training harder and faster isn’t actually one of them!
Having a good aerobic baseline is critical, but too many runners – thinking it’ll make them quicker – run too fast all the time, leading to burn out and frequent injury.
It may sound weird, but to run faster, you might actually have to slow down – at least for a while.
Aim to run around 80% of your mileage at a slower pace (especially your long runs), where you can chat easily, and you’re not out of breath, and the remaining 20% doing some harder workouts.
Spend 2-3 months building this easy base; the speed work can come after that.
Consistency is the golden rule, and will lead to more solid results in the long term.
What I mean by ‘consistency’ is staying injury free, recovering well from workouts, and progressive regular training; rather than peaks and troughs of hard training/time off with injury or fatigue.
I’m also a firm believer in mixing things up with cycling, rowing, swimming and strength work; which will feed into the consistency ‘theory’. It’s always better to do slightly less running but stay healthy, well and injury free, than break yourself and have to take time off.
This is the one right? Speed work will make you faster. Well yes to a certain extent it will, but only as part of the overall ‘running jigsaw puzzle’. Check out our post on 3 ways to sneak speed into your training plan.
Consistency, recovery, injury prevention, overall mileage, and speedwork are all in the ‘pot’ and you need to work out your own personal recipe.
Speed work can be great, but treat it with a touch of caution, and start with a speed workout every 10-14 days, and monitor fatigue and pain closely. You could try one of these workouts.
Runners by nature aren’t patient; We want results and we want them now! But running is a lifelong activity, and it’s not always about speed and how fast you can run. Learn to be patient and allow the results to come to you instead of chasing it too hard.
How can I get rid of a stitch?
Stitches are a common problem, not normally medically serious, but annoying and painful.
A classic stitch is a sharp stabbing pain or ache in your stomach just below your ribs. It’s usually on one side (normally the right) and often accompanied by a pain in your shoulder.
Some runners seem more prone to them than others, and it’s often beginners who seem to suffer the most.
‘Unfortunately, no-one really knows what causes a stitch’ explains Dr Mark Wotherspoon, Sports and Exercise Medicine Consultant at Perform Southampton in the UK said, ’It’s likely to be some sort of spasm or cramp of the diaphragm, a feature of not being fit enough or poor conditioning, since stitches usually affect beginners or runners increasing intensity or load too quickly’.
If you do suffer from stitches, you need to try and identify what causes them, and then find ways to prevent them. This is often not an easy task, as stitches often come on without warning and it’s hard to link them with anything specific.
However, there is a general consensus, that beginner runners seem to suffer the most, indicating that stitches are possibly linked to fitness.
In addition, runners pushing the pace or gearing up for speed work are often struck down with a stitch. It’s likely that as you get fitter, you’ll be less likely to get a stitch.
In terms of getting rid of it, there are lots of theories; massaging the site of pain; pushing your fingers into your belly; or deep breathing. However, I’ve developed a breathing technique that seems to work 9 times out 10. Next time you get a stitch.. give it a try:
Sarah’s Stitch Technique
- Take a big deep breath in as far as you can.
- With an open mouth and relaxed (not pursed) lips, do a really hard, fast and forceful breath out, pushing your breath out as long and hard as you can. Imagine you’re pushing your breath out from the bottom of your belly and you should feel your stomach muscles contract and keep pushing the breath out until you run out of puff.
- Repeat this 5-6 times. It does sound like you’re having a heart attack, so warn other runners beforehand.
It might not be a pretty technique, but it seems to work 90% of the time!
*One final note on stitches. If you have ongoing abdominal or chest pain that’s not going away, do get checked out by your Doctor, as it may not be a stitch and may be more medically serious.
Hopefully these tips have been helpful to you, particularly if you are just starting out as a runner.
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Runner’s Knee Pain: Causes, Symptoms, and How to Fix It
What Is Runners’ Knee?
Knee pain from running is so common of an occurrence that the term “runner’s knee” has become a commonplace way of describing a number of conditions that cause knee pain, and often pain around the front of the knee (AKA, patellofemoral pain). Frequently, runner’s knee refers to patellofemoral pain syndrome where the back of the kneecap comes in contact with the thigh bone, causing knee pain with running. But this term can apply to a number of running-related injuries.
The good news is there are a number of non-surgical ways to treat runner’s knee pain.
What Causes Knee Pain When Running?
There are a variety of knee injuries from running or conditions that may make the knee hurt after running or during the act. When and where such pain develops can be telling as to what is causing knee running pain.
Alignment issues can be either a direct or indirect cause of knee pain and running. Flat feet or overpronated feet (excessive inward rolling of the foot) can lead to knee pain while running or after running as this causes alignment issues with the kneecap. (Check out our arch support inserts.) Similarly, unbalanced, tight or weak leg muscles may cause alignment troubles and result in running knee pain.
Such problems can also increase one’s risk of a subluxated or a complete or partial kneecap dislocation, which can cause substantial runners knee pain.
Major increases in distance or pace can cause knee pain after running or during running. Overdoing it can strain or irritate the soft tissues of the legs and knee, causing knee pain after running or while one is running. Not surprisingly, new runners often experience knee pain.
Excessive stress on the knees can wear down the kneecap cartilage, causing conditions like chondromalacia or arthritis.
It is important not to ignore runners’ knee symptoms such as pain, swelling, stiffness, etc. If the knee hurts when running or after, this is the body’s warning signal that something is wrong. Ignoring a sore knee from running or running through knee pain is a sure way to do further damage and possibly cause permanent running knee problems, like arthritis. Many medical professionals recommend avoiding running with knee arthritis.
Runner’s Knee Symptoms
Symptoms of runners’ knee vary depending on the injury and the person. If one is experiencing pain below the kneecap after running he or she might be experiencing patellar knee tendonitis from running. At its onset, patellar tendonitis pain may only be present at the beginning of one’s workout or one may experience pain in the knee after running. Ignoring this discomfort may lead to near constant pain in the knee from running.
Damage to the cartilage below the kneecap is another possible knee injury from running that causes anterior knee pain. When this occurs, it is known as either patellofemoral pain syndrome (PFPS) or chondromalacia. This condition causes knee pain around the kneecap and/or pain behind the kneecap. Heightened knee pain when running downhill, climbing stairs, squatting or sitting for an extended period may sign one’s kneecap cartilage is breaking down or has eroded.
Outer knee pain when running (lateral knee pain) may indicate one’s iliotibial (IT) band at the outer part of the knee is irritated, especially if one is a long-distance runner. IT band syndrome (ITBS) is often a source of knee and hip pain from running long distances.
Sharp pain in the knee when running may be a sign of a meniscus tear. Whether one has experienced a medial or a lateral meniscus tear will determine if the individual experiences inner knee pain with running or outside knee pain when running, respectively.
Soft tissue injuries are the most common reasons for back of knee pain from running (posterior knee pain), though injuries to the popliteal muscle that is important to running downhill can also cause posterior knee pain with running. If one steps in a pothole or loses one’s balance on an uneven surface, twisting the knee, one might tear a ligament such as the anterior cruciate ligament (ACL) that stabilizes the knee. An ACL tear typically causes intense pain behind the knee or at the outside of the knee and swelling, instability and limited movement.
Regardless of what one thinks may be the culprit for knee problems linked to running, he or she should always seek a professional diagnosis regarding what exactly is causing the sore knee after running and how to cure runners’ knee. Runners’ knee recovery time will depend upon the knee problem and its severity as well as the patient’s age, health, etc.
How to Fix Runners’ Knee
Running and knee pain do not have to be permanently linked; there are a number of steps one can take to alleviate runner knee pain. However, just what helps will vary depending on runners’ knee causes and the person. The following are some general guidelines when it comes to how to heal runners’ knee. However, this is in no way intended as a substitute for professional advice.
Resting the knee and giving it a chance to heal are some of the first steps for runners’ knee recovery. Protecting the vulnerable knee is another priority when it comes to knee problems from running.
This might involve wearing knee braces or knee wraps for running. Such products provide lightweight support to the knee and protect against movements that might cause more damage.
Knee pads for running may be a good option for some, especially those involved in contact sports.
Some knee sleeves for running can also help with patellar tracking, similar to athletic bandages or Kinesio tape (kt tape) for runners’ knee. Such knee orthotics for runners’ knee are much simpler to apply than learning how to tape a knee for running.
Besides rest, healing runners’ knee may well involve elevating and icing the knee as well as applying compression. These steps can help bring down knee swelling after running. The latter also promotes blood flow and healing. A knee sleeve for running will apply beneficial compression. Some choose to wear such products as a way of preventing runners’ knee.
An even lighter weight option of applying compression might be wearing running knee socks. Such products have the added benefit of warming the calf.
Another way to cure runners’ knee is to engage in runners’ knee exercises to strengthen the muscles of the leg so that less stress is put on the kneecap. Knee strengthening exercises for runners can also help correct muscle imbalances or tracking problems that may be causes of knee pain in runners. Tight muscles can also cause a sore or stiff knee after running. Stretches for runners’ knee can help. Indeed, warming up properly and engaging in knee stretches for runners can help prevent an injury from occurring in the first place.
Cylinders of foam known as foam rollers can also help relieve knee pain. Foam rollers help runners knee as “rolling” the muscles that attach to the knees can help maintain flexibility and alignment of the joint. Find more foam roller exercises for the knee here.
Another good practice is to make sure to wear proper running shoes for knee pain. With today’s wide selection, one can even undergo tests to make sure one gets the best running shoes for one’s knee pain. The best running shoes for runners’ knee will support the foot, including the arch. For some, simply switching shoes is sufficient as a runners knee cure.
For more serious injuries like a ligament tear, extensive runners knee rehab including time with a physical therapist may be needed and possibly surgery to relieve knee pain from running. As one gets back to running, he or she may need a functional post-op knee brace for added protection and support for running after knee surgery.
Preventing Runners’ Knee
Warming up is an important component of a workout if one wants to avoid knee soreness after running. Improving the strength and flexibility of one’s leg muscle is another important step for avoiding pain in the knee when running in the first place.
It is important for runners to gradually increase mileage to prevent knee pain while running. Runner’s World recommends stepping up one’s mileage less than 10% per week. Knee pain after running long distances that the body is not used to is not surprising.
Another key when it comes to avoiding knee problems for runners is to wear proper gear. Most important is getting the best running shoes for one’s knee problems, meaning ones that are well suited for one’s arches and gait.
Being overweight or obese can take a major toll on one’s knees. For that reason, it is important to maintain or get to a healthy weight if one wishes to avoid running with knee pain. Long-term damage to the knee can cause arthritis or possibly even lead to knee replacement surgery. Medical professionals generally advise against high impact activities like running after knee replacement surgery.
And finally, using proper running form and being selective about one’s terrain is also important for avoiding knee pain with running. Running straight down a steep hill or on uneven ground increases one’s risk of knee pains from running.
Common Knee Injuries from Running
When most people think of running, they view it in the light of something that is beneficial for your body. While that is true in that it can improve your heart health, help with weight loss and provide a boost in mood or self-esteem, there is also a downside to running. Namely, the repetitive motions and impact of “pounding the pavement” can take a toll on the body.
For this reason, it is important to pay attention to any foot, hip or knee pain from running and to take steps to address any such pain. It is also important to engage in “safe practices,” if you will, relative to running. I will go into more detail on how to relieve knee pain from running and how to ward off future injuries momentarily. But first, I will detail a few common running knee injuries.
Runners’ Knee Pain
The term “runners’ knee” is a general term for knee pain associated with running. (This condition is similar to Jumper’s Knee.) Typically, this includes knee pain while running and in some cases knee pain after running in the vicinity around or behind the patella (kneecap).
Runners’ knee, also known as patellofemoral pain syndrome, can be brought on by a number of things. For one, overuse can irritate the nerves of the knee and overstretch the tendons, resulting in running knee pain.
Besides knee pain, running injuries of the patellofemoral pain syndrome variety can also cause tenderness, cracking sensations or knee instability. There are a number of knee braces for runners that can help ease knee pain and provide support.
Misalignment of the bones can also cause knee pain when running as this can result in too much weight or force being put on areas of the body that are not equipped to handle it. This, in turn, increases one’s risk of damaging the knee joint.
Misaligned bones can be due to misshapen or ill-fitting bones in the knee joint, or an abnormally high or flat arch of the feet. Knees that bow out or bend it can also result in abnormal weight distribution on the bones that leads to runners’ knee injuries.
Runners’ knee is estimated to be up to two times more common in women than men, according to the British Journal of Sports Medicine. This is largely due to the greater angle between the thigh bone and the knee that results from the wider hips of the female sex. This puts more stress on the knees.
Muscular issues can also cause the patella to mistrack. Weak quadriceps muscles or especially tight leg muscles that cause one to run with some of the aforementioned atypical forms are associated with running and knee pain. BraceAbility offers knee braces specifically designed to improve the tracking of the patella.
Running can also cause cartilage of the knee to wear down. This can result in knee pain with running, often in the area just below the kneecap.
Outside Knee Pain: Running with ITBS
Another fairly common source of runner knee pain is iliotibial band syndrome (ITBS). This injury is especially common among distance runners and it typically causes lateral knee pain when running. ITBS is thought to be the most common source of outer knee pain from running. The pain in knee when running associated with ITBS typically fades quickly once one stops the activity.
So what causes ITBS? Well, the iliotibial band is a thick band of tissue that runs along the outside of the leg from the hip to the top of the shin bone. Its primary function is to control abduction of the thigh.
When one is running, the IT band slides back and forth over a bony structure known as the lateral femoral epicondyle (the bump in the thigh bone near the knee). Too much of this action can cause the band to become inflamed, resulting in painful friction on the lateral part of the knee as one is running.
There are a number of factors that can increase one’s likelihood of experiencing this type of runner knee pain, including major foot pronation (see “Pronation, Explained”), running in worn-out shoes, differing leg lengths, tight leg muscles or being bow-legged.
Inner Knee Pain: Running & Plica Syndrome
Plica syndrome is much harder to diagnose than the aforementioned conditions. The quick definition of plica syndrome is that this refers to irritation of the lining of the knee joint that often results in running knee problems. Plica refers to thin remnants from the fetal stages of one’s early developments that are located in the sleeves of the synovial folds; more specifically, these appear as an extension of the synovial capsule.
When the synovial capsule is irritated from activities such as running, plica thicken, making it more likely to get caught on the femur (thigh bone) or pinched between the femur and the patella. This typically causes medial knee pain with running, along with a catching, locking or a crackling sensation/sound of the knee.
Overuse, as well as tight hamstrings and/or weak quadriceps muscles, can increase one’s likelihood of developing plica syndrome.
Running Injuries: Knee Bursitis
The knee has 11 bursa or small lubricating sacks. Irritation of the bursa can also cause knee pain. One of the more common running injuries to the knee is pes anserine bursitis. This refers to irritation of the bursa located between the tibia (shin bone) and the three tendons of the hamstring muscle at the inside of the knee. This irritation can stem from overuse and friction, resulting in inside knee pain with running and other repetitive activities.
Again, tight hamstrings and being bowlegged can increase one’s risk of developing this injury, as can obesity or osteoarthritis. Suddenly increasing one’s distance or the number of hills in one’s run can also increase one’s risk of bursitis-related pain in the knee after running.
Bursitis knee pain from running typically develops gradually inside the knee and/or near the center of the shinbone a few inches below the knee joint. The intensity of the pain often increases with activity or climbing stairs.
Knee Pain Running Treatment
BraceAbility offers a wide selection of Knee Injury Treatments, including treatments for general knee pain and treatments for jumper’s knee or runner’s knee. You can likely infer a number of the knee pain treatment and preventative steps from the descriptions of the risk factors for developing runner’s knee pain. First, it is important not to “muscle through” knee pain. Pain is a red flag that something is wrong. Heed it and seek the help of a professional.
Most instances of knee pain and running can be remedied by conservative treatments. The first line of defense is often engaging in the steps of RICE—rest, ice, compression and elevation—possibly with the use of an over-the-counter anti-inflammatory medication. A doctor can recommend a number of knee injury stretches and exercises to strengthen and improve the flexibility of key leg muscles.
When one gets back to running, it is important to always stretch and warm-up before a run. The use of proper running shoes for knee pain avoidance is also important. This includes wearing shoes that are supportive and suited to your foot and gait.
Wearing an appropriate amount of clothing for the weather is also important for preventing sore or tight muscles. Use of a knee brace for runners or a runner’s knee band may also provide some useful extra support and a boost in circulation that can promote healing as one eases back into training.
When in recovery mode from a knee injury, one should avoid hilly, uneven terrain. And when one does begin working hills back into a workout, this should be done gradually with attention to form. The same can be said for adding miles to one’s run. Watch this video on proper, safe and efficient running form:
Strength training and cross-training for more balanced strength throughout the body is also important for knee injury prevention.
Unfortunately, there are times when conservative methods are not effective. In such cases, more invasive methods such as injections or surgery may be needed to relieve knee pain from running.
View our related blog posts on this topic:
Patellar Tendonitis Treatment and Surgery
What is Jumper’s Knee and how is it Caused?
Treatments for Knee Joint Pain
5 Beginner Running Injuries (and How to Avoid Each)
If you’re new to running, you’re unfortunately also new to a whole world of aches and pains that come mostly from adding too much mileage too soon. But starting-or returning to-a running routine doesn’t need to cause you trouble. After all, there are a few basics for avoiding injury-and some don’t even have anything to do with how you hit the pavement. (Psst! These are the 5 Exercises Most Likely to Cause Injury.)
So as for your specific aches, we’ve solved ’em. Here are five common injuries, plus how to avoid and relieve them once they strike.
Patellofemoral pain syndrome, better known as “Runner’s Knee,” is a catchall for soreness that strikes around the kneecap. Irritation of the tendons, cartilage, fat pad beneath the patella, or other tissues could be the culprit thanks to any number of maladies like overuse, muscle imbalance, foot problems, a misaligned kneecap, or something else.
Avoid it: Strengthen your quadriceps and glutes, says Mike Silverman, a physical therapist at Hospital for Special Surgery’s Sports Rehabilitation and Performance Center in New York City. This will help move the load from your knees to your legs. Use a foam roller to keep your IT band loose and mobile, and keep your hamstrings, quadriceps, and calves limber with dynamic stretches (like these 6 Active Stretches You Should be Doing).
Relieve it: “If you do develop runner’s knee, foam rolling is a great way to reduce symptoms,” Silverman says. In addition, ice your knee and use elastic therapeutic tape, like Kinesio or KT Tape, to stabilize your patella as a three-pronged approach.
Iliotibial Band Syndrome
The iliotibial band-a ligament that stretches from your pelvis to shin along the outside of your thigh helps stabilize your knee when you run. If it becomes too tight, you might feel a nagging knee pain.
Avoid it: As with runner’s knee, strengthening your glutes is key, along with using a foam roller to knead out your IT band, Silverman says. Add mileage gradually, toss worn-out shoes, go easy on downhill running, and change directions often at the track.
Relieve it: If you didn’t roll before IT band syndrome, it’s time to start. “Foam rolling can help with the pain,” Silverman says. Add in glute, hamstring, and quad stretches too. (Get Loose! The Best IT Band Stretches.)
The plantar fascia is a fibrous band of tissue in the sole of your foot stretching from your heel to your toes. Tiny tears in the fascia cause inflammation and, with it, intense heel pain. You’ll often feel it more in the morning or after long periods of sitting or standing.
Avoid it: Keep your lower legs and feet limber with stretches for your calves and plantar fascia, in addition to arch strengthening exercises.
Relieve it: If you develop irritation under your foot, a night splint can help, Silverman says. “Rolling a golf ball or frozen water bottle on the underside of your foot works too.”
The piriformis muscle in your posterior stabilizes your hip joints, maintains your balance, and allows you to shift from foot to foot. When the muscle compresses the sciatic nerve with too much force, you might feel pain in your derriere or tingling that travels all the way to your toes.
Avoid it: We’ve said it before and we’ll say it again: “Strengthen your glutes to prevent the piriformis from getting tight and irritated,” Silverman says. Also, core work-including your abs, back, and pelvic muscles-is key.
Relieve it: Grab a lacrosse or tennis ball to roll out your glutes, digging deep into the muscle. “Rolling both before and after you run can help decrease symptoms,” Silverman says. Keep the ball handy to roll intermittently throughout the day as well. (Try one of these 6 Ways to Relieve Sore Muscles After Overtraining.)
Posterior Tibialis Tendonitis
The posterior tibialis tendon has one important job: arch support. The tendon connects your calf muscle to the inside of your ankle. When it becomes irritated, inflamed, or torn, you might be looking at foot and ankle pain, along with arches that fall slowly over time resulting in flat feet.
Avoid it: Before buying those cute kicks, visit your local running store to have your feet assessed. Your arch height determines how much your ankle rolls inward or outward when you run, and consequently, what shoes might work best for you-a neutral shoe that allows your foot to roll naturally inward, or a stability or motion control shoe that restricts movement in one direction or another. “Making sure you’re running with the correct shoe can limit a lot of potential injuries including tendonitis,” Silverman explains. Also, strengthening your lower leg-and calf in particular-can prevent some of the pain that plagues novice runners.
Relieve it: Massage and ice the area to ease symptoms, Silverman says. Rest or switch to low-impact exercises that take the burden off your feet for a while, and consider being fit for orthotics. (If you’re just getting into a workout routine, make sure you’re not pushing yourself past your limits. Check for these 5 Telltale Signs You’re Overdoing It.)
- By Karla Bruning
Working out can be uncomfortable (especially when you’re just getting started), but it should never hurt. Here is how to tell the difference between the harmless twinges that go along with pushing your muscles farther than they’ve gone before and pain that should send you to your doctor.
Remember: When in doubt, rest and have your pain checked out. It’s better to spend a little time and money seeing the doctor than to be sidelined for months by an injury that you could have prevented or minimized.
Related: Want to start running? The Big Book of Running for Beginners will take you through everything you need to know to get started, step by step.
RUNNER’S KNEE (PATELLOFEMORAL PAIN SYNDROME)
This condition is an irritation under the kneecap that can flare up during a workout or while descending hills and stairs. It’s often caused by weak quads, hips, or glutes, which all can lead to overpronation (excessive inward foot rolling) and cause poor tracking of the knee. Running with too much forward lean can also contribute to the problem. How do you know you may have this? You may feel twinges early in the workout that go away and reappear. As it worsens, the pain may be on the inside or outside of the knee (toward your other knee or toward the outside of your leg), which persists even after you’re done with your workout.
What to do: Take at least three days of rest until you’re pain-free. Avoid downhills or leaning too far forward during your workouts, as this can put more stress on your knees. And strengthen your quads, which control the tracking of your knees.
Safe alternatives: Elliptical trainer, swimming, or pool running.
See our page on runner’s knee
ILIOTIBIAL (IT)-BAND SYNDROME
This is a strain within the IT band, the connective tissue that runs along the outside of your thigh, from your hip to your shin. When your knee flexes and extends during running, the IT band can rub against the bone, causing irritation. It can feel like a dull pain on the outside of your knee that starts about 10 to 20 minutes into a workout. As it gets worse, it can radiate up and down your leg, even while you’re walking downstairs or down a hill. Piling on too many miles too quickly can irritate the IT band, as can running on cambered (slightly arched) roads.
What to do: At the first sign of pain, rest for a few days. Also, get your shoes checked; you might need orthotics or a pair that offers more arch support to help correct the pronation.
Safe alternatives: Swimming, pool running, and using an elliptical trainer. (Avoid hiking and cycling, which can aggravate IT-band syndrome.)
See our page on iliotibial band syndrome
SHIN SPLINTS (MEDIAL TIBIAL STRESS SYNDROME)
Shin splints happen when there are small tears in the muscles around your shinbones. You might feel a tight aching pain that fades after a warmup or after you stop working out. It can feel painful and tender to the touch. Shin splints are common among new runners and those returning after an extended layoff, and after building up mileage too quickly. Overpronation, running on cambered (arched) roads, and wearing worn-out running shoes can also lead to shin splints.
What to do: When you feel the first twinges of pain, rest, then slowly get back into working out. If the pain continues through the end of your run and radiates over a wide area, it could be a stress fracture; see a doctor for a bone scan to rule one out. The easiest and best way to avoid shin splints is to increase mileage gradually, run on soft surfaces as much as possible, and make sure your shoes offer the fit that your feet need.
Safe alternatives: Cycling, pool running, and swimming. (Avoid the elliptical trainer.)
See our page on shin splints
Unlike an acute fracture that happens as the result of a fall, stress fractures develop from cumulative strain on the bone. They most often occur in the foot or in the shins. It may begin as minor pain and get worse as you run. If it goes untreated, it may become uncomfortable just to be on your feet. Stress fractures can result from overtraining, overstriding, and excessive impact. If you increase the duration, intensity, or frequency of your workouts before your body is ready, your bones can’t repair themselves fast enough to keep up. Stress fractures are more common in women than in men, usually due to nutritional deficits, low estrogen levels, and inadequate calorie intake.
What to do: Stop all impact exercise and see a doctor right away for a bone scan. The amount of rest you’ll need depends on the severity of the fracture and its location. If you ran through the pain for a while before you realized you had a fracture, your recovery could take longer.
Safe alternatives: Swimming and pool running. (Avoid all impact exercise until cleared by the doctor to resume.)
See our page on stress fractures
PLANTAR FASCIITIS (PF)
An inflammation of the plantar fasciae, tendons on the bottom of the foot, from the heel to the toes. It feels like a dull ache or bruise along the arch or on the bottom of the heel, and it can be most painful first thing in the morning and at the beginning of a workout. Overpronation and wearing worn-out shoes are the most common causes of PF. A sudden increase in hill running or running on the forefoot can also set it off, as can long periods of standing. Those with high arches are more at risk for PF, and often it’s made worse if you wear shoes with no arch support or often walk around barefoot.
What to do: You don’t have to stop working out—just stick to flat surfaces and avoid hills. Avoid wearing flip-flops or open-backed shoes that offer no heel support. Replace your running shoes every 300 to 500 miles. Stretch your calves and strengthen your glutes, which can help prevent pronation.
Safe alternatives: Pool running and swimming. Cycling or using an elliptical trainer can help you maintain fitness, but only if you can do those activities pain-free.
See our page on plantar fasciitis
This is felt as chronic achiness and tightness that forces you to slow down and shorten your stride. As it gets worse, the pain can become sharp. Overstriding, overextending your legs while trying speed up, or bending forward from the waist too much to increase your forward lean can strain the muscles in the back of the thighs. Going too far or too fast, too soon or doing too many hills can also strain the hamstrings. Such strains often happen because these muscles are weak and tight.
Best remedies: Run easy, and shorten your stride. Avoid stretching your hamstring while it’s sore, which could actually pull it or strain it further.
Safe alternatives: Swimming or the elliptical trainer. (Avoid cycling, which can put stress on your hamstrings.)
This condition is the tightening and irritation of the Achilles tendon, which connects the two calf muscles to the back of the heel. It may start as a dull ache. As it progresses, it may hurt to stand up on your toes, and you may develop severe pain and swelling—even when you’re not running. It’s caused by doing too much too soon, doing too many hills, or wearing the wrong shoes.
What to do: Rest for a few days. If you try to run through this, it may take months to go away. Avoid aggressive calf stretching and wearing flip-flops and high heels, all of which can irritate the Achilles.
Safe alternatives: Pool running, swimming, and biking. (Avoid elliptical trainers, which can strain the calf muscles and the Achilles.)
See our page on Achilles tendinitis
Once injuries have healed, get back on the road with the Start Running Plan.
Knee pain in a beginner runner- rest more, get a brace/sleeve, or ignore?
Don’t ignore pain. If the pain persists I would see a doctor. You might want to wait a few days to see if it subsides, in the meantime I would do gentle exercise only.
I tend to follow the following rules:
If something starts hurting a lot during a run, curtail my run rather than risk making it worse.
I try to be mindful of my running form so that I’m minimising the stresses on my body and running with the least amount of effort in an efficient way. As a beginner, your running form is probably not very good unless you are a natural, but over time it will probably improve if you pay attention to it.
After a long / hard run, some muscle soreness is normal, and maybe some niggling aches/pains – if this is the case ease off or don’t run the next day or so to allow some recovery. The niggles are also a sign something needs attention or improvement.
Noticeable (e.g minor muscle/tendon pull) pain is a sign I over-reached and need to improve my base level before moving up. Also if I suspect that I’ve done this I may extend my recovery period as running with an injury will make it worse. However I find in minor cases gentle exercise (walking, light running) often helps.
If it doesn’t go away after several days then that’s not a good sign, see a doctor.
Pain is your friend, it’s telling you you’ve done something wrong in approximate proportion to how much it hurts, basically.
Also, I think for beginner runners, it’s easier to overextend yourself, as doubling your distance from 1/2 mile to 1 mile is much easier than it is to go from 10 miles to 20 miles even though in many cases a similar amount of improvement is needed.